When Does a Rotator Cuff Tear Hurt? A Critical Review of the Literature

With increasing age, rotator cuff tears are common in symptomatic and asymptomatic patients. Yet, there remains a limited understanding of the etiology of pain associated with rotator cuff pathology. Recent research has associated patient perception, resilience, repair integrity, tear size, biomechanics of the humeral head, and muscle kinematics with pain levels. However, the evidence remains largely inconclusive in answering the fundamental question regarding why some patients experience symptoms severe enough to warrant surgery and others remain completely asymptomatic. A deeper understanding of the causes of pain with a rotator cuff tear can guide treatments to optimize pain relief in symptomatic individuals seeking treatment.